There’s a reason you have to get a pre-op physical exam for any non-emergent surgery. Figuring out if you’ll wake up from the anesthesia at all is part of the calculus that determines whether the benefits of the procedure outweigh the risks.

Another option for diabetes are the SGLT-2 inhibitors like Jardiance. They work by making you pee out all the excess sugar. You won’t have the diarrhea issues, but you will be peeing a lot. (It’s basically a special diuretic, so it’s also really good for blood pressure.) Bonus: they’ve also gained approval for slowing the progression of diabetic nephropathy (kidney disease), so if that’s something you have any trouble with, it can help get it covered.

One of the biggest problems with the GLP-1’s (Ozempic, etc) is the fact that people lose weight by just not eating as much, and the things they do eat aren’t likely to be very nutritious. Protein malnutrition and muscle wasting are very common sources of weight loss on Ozempic. That’s why it’s standard of care to get your patient to a licensed dietician before starting them on one of those drugs if at all possible.

The BMI number that is calculated just from weight and height is really just a number that tells us we need to go look at some other numbers. The other numbers are things like body fat percentage, cholesterol levels, blood pressure, blood sugar, etc. It is entirely possible for someone to have a “normal” BMI and still be very fat and unhealthy, and those people are pretty easy to identify visually, just as someone with a “high” BMI who is a powerlifter or something is very easy to visually identify.

I’m a medical student and I have some direct experience with this. Sometimes, the difference between the surgeon who will do the procedure versus the surgeon that won’t do the procedure is the availability of specialized facilities and equipment that they have access to. An elective surgery (i.e. not an emergency surgery) can go from routine to very high risk depending on the amount of adipose tissue the patient has.

And it’s not just a matter of the fat tissue overlying the surgical site. Morbidly obese patients are much more likely to have things like sleep apnea which can make anesthesia more risky and might require more specialized equipment than a particular surgeon/hospital/anesthesiologist might have access to. The “morbid” part of “morbid obesity” also refers to the fact that people above a certain threshold of weight are much more likely to have other health conditions like heart disease that make anesthesia more risky.

If by “shit takes” you mean “sexual harassment scandals”, sure. Either way, he’s the walking epitome of “um…ackshually…” in a way that makes him profoundly distasteful to most of the population.

I believe you are making a joke, but I realize that I should explain the terminology.

Someone “coding” means that their heart or breathing stopped and “calling a code” means getting all the relevant equipment and personnel to do CPR to make them not dead anymore. (CPR is quite literally necromancy and you cannot convince me otherwise.)

The immortality elixirs usually come with some amount of eternal youth or prevention of illness. If someone is healthy and able to interact with the world, that’s one thing. But someone with lung metastases or emphysema who is just lying there, drowning in their own lungs for however long…that is a life not worth living. If you could stay healthy forever, then being alive forever would just be a test of your tolerance for loss.

Working in medicine, especially emergency medicine, I have to hold on to this kind of mindset very tightly. I see death frequently. I have had infants die in my care, and there is nothing I could have done to save them. I have had frail, miserable, elderly people in my care that have been kept alive through titanic and terrible measures, and their lives would have been so much better overall if they had been allowed to pass peacefully a few years earlier.

I saw another post yesterday about the old and infirm lying in nursing homes, staring at the ceiling, coding, then being dragged back to life by the heroic efforts of the staff and the ER…just to go back to staring at the ceiling for another year.

It seems counterintuitive as a physician (in training), particularly in emergency medicine where our whole job is to steal from the reaper, to advocate for sooner, more peaceful, more autonomous deaths. I have always been a proponent of physician-assisted suicide because I have seen too many people whose lives would have been better if they had been shorter.

The problem with looking at “average wages” is that you’ve got outliers like “Spiders” Elon over there fucking up the numbers.

As an ED tech, I had to clean up C diff and chemo diarrhea off patients, beds, floors, and commodes multiple times. ED boarding meant that patients that should have been admitted to hospital rooms that had a bathroom attached were stuck in the ED for hours or even days.

I worked as an assistant in a plastic surgery office for a while as well, and I had to clean lipoaspirate out of the suction tube/syringe and the erlenmyer flask it was emptied into. That was still preferable to the time it got splattered on my scrubs because the surgeon emptied it into a kidney basin the first time. (The flask was my idea to prevent getting splattered again.)

As a former ER tech that had to hold up a belly that size for 30 minutes for a doctor to put in femoral central lines…I feel your pain. (literally)

Occupational therapy is a thing, but it is a very different thing. Occupational therapy is part of rehab that helps patients regain or retain activities of daily living like dressing, bathing, and feeding themselves, etc.

Yeah, my old desktop computer is getting turned into my first dedicated Linux machine and my current desktop isn’t getting updated to 11 until October 13th.

“Then” means that you will be doing something subsequently. “Than” means that you will be doing something instead of something else. Normally this is a grammatical nitpick, but it actually changes the meaning of your sentence by using the wrong word.

Subaru has great safety ratings and the “used Subaru tax” (as in, a used Subaru tends to be more expensive) is because they are very good cars. They have some of the best safety ratings on the market.

…except that we do know what gets put in every medication. Every ingredient has to be registered and tested, and if they change the formulation at all, they have to test it again to make sure it’s safe.

The problem with that is that there are already too many children in need of good homes and some of these parents are very good in every other respect. The people who push anti-vax stuff need to be made into public examples, but the rank-and-file believers are usually just well-meaning dupes.

They see that rash as not that scary, and the rash is honestly the mildest part of the disease. Measles can cause encephalitis (brain swelling) and kill the child, it can cause pneumonia and kill the child, they can recover from the illness and be completely fine for a few years until the virus reactivates and their entire central nervous system becomes intractably inflamed and they seize until they die. And there’s nothing we can do about any of those complications besides things like IV fluids or ventilatory support because there are no antiviral medications effective against measles, so we just have to hope the child’s immune system wins.